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Study Finds 21 Percent of Patients are
Misdiagnosed
A study
published in the Journal of Evaluation in Clinical Practice on April 4,
2017, found that more than 20 percent of patients are misdiagnosed. The
study titled "Extent of Diagnostic Agreement Among Medical Referrals"
looked at the diagnosis originally given to patients and compared that to
the diagnosis later given upon the patient seeking a second opinion.
 The
study reviewed the records of 286 patients who were referred by their
primary care doctor to the Mayo Clinic's General Internal Medicine
Division in Rochester, Minn., over a two-year period from Jan. 1, 2009 to
Dec. 31, 2010.
Overall,
the results showed only 12 percent of those seeking a second opinion at
the Mayo Clinic had their diagnoses confirmed. However, 21 percent of the
patients had their diagnosis completely changed, while 66 percent of those
patients received a refined or redefined diagnosis. Overall, the study
showed that almost 88 percent of patients seeking a second opinion at the
Mayo Clinic receive a new or refined diagnosis.
Previous
research cited in the new study showed that errors in diagnosis
"...contribute to approximately 10 percent of patient deaths."
Additionally they "…account for 6 to 17 percent of adverse events in
hospitals."
"Effective
and efficient treatment depends on the right diagnosis," said study
co-author James Naessens, a health care policy researcher at the Mayo
Clinic, in an April 4th press
release in Science Daily. "Knowing that more than 1 out of every 5
referral patients may be completely [and] incorrectly diagnosed is
troubling -- not only because of the safety risks for these patients prior
to correct diagnosis, but also because of the patients we assume are not
being referred at all."
In a
Washington Post article, Mark L. Graber, a senior fellow at the research
institute RTI International and founder of the Society to Improve
Diagnosis in Medicine, who was not involved with the study noted,
"Diagnosis is extremely hard. There are 10,000 diseases and only 200 to
300 symptoms." He added, "Doctors are humans, and they make the same
cognitive mistakes we all make. If you are given a serious diagnosis, or
you're not responding the way you should [to medication], a second opinion
is a very good idea. Fresh eyes catch mistakes."
Second
opinions are still encouraged, but the concern is that they may be limited
due to in-network insurance issues preventing patients from seeking second
opinions. In response to the problem of diagnosis error, the National
Academy of Medicine has called for dedicated federal funding for improved
diagnostic processes and error reduction.
It is
obvious that there is an increase in cost both in diagnosis and medical
treatment if the first diagnosis is not confirmed by the second opinion.
However, Naessens sums up the concerns if a second opinion is not sought
saying, "Total diagnostic costs for cases resulting in a different final
diagnosis were significantly higher than those for confirmed or refined
diagnoses, but the alternative could be deadly."
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